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癌症患者对SARS-CoV-2疫苗接种的免疫反应:一项前瞻性研究。

Immune Response to SARS-CoV-2 Vaccination in Cancer Patients: A Prospective Study.

作者信息

Caramujo Cecília, Gomes Inês, Fraga Teresa, Paulo Judy, Broco Sofia, Cunha Nuno, Madeira Pedro, Carvalho Teresa, Teixeira Margarida, Sousa Gabriela

机构信息

Medical Oncology, Instituto Português de Oncologia de Coimbra Francisco Gentil, E.P.E., Coimbra, PRT.

Pathology, Instituto Português de Oncologia de Coimbra Francisco Gentil, E.P.E., Coimbra, PRT.

出版信息

Cureus. 2023 Apr 1;15(4):e37014. doi: 10.7759/cureus.37014. eCollection 2023 Apr.

Abstract

Introduction Cancer patients on active treatment are at increased risk of developing coronavirus disease 2019 (COVID-19), making effective immunization of the utmost importance. However, the effectiveness of vaccination in this population is still unclear. This study aims to evaluate the response against COVID-19 in a cohort of patients with active cancer under immunosuppressive therapy. Methods This was a prospective, cross-sectional, single-center study that included patients with cancer under immunosuppressive therapy vaccinated against COVID-19 between April and September 2021. Exclusion criteria were: previous known severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, single-dose vaccine or incomplete vaccination scheme. Immunoglobulin G (IgG) anti-SARS-CoV-2 antibody levels were assessed using 35.2 binding antibody units (BAU)/mL as the positive cut-off. Assessments were performed 14-31 days after the first and second dose and three months after the second dose. Results A total of 103 patients were included. The median age was 60 years. Most patients were being treated for gastrointestinal cancer (n=38, 36.9%), breast cancer (n=33, 32%) or head and neck cancer (n=18, 17.5%). At evaluation, 72 patients (69.9%) were being treated with palliative intent. The majority were being treated with chemotherapy (CT) alone (57.3%). At the first assessment, levels of circulating SARS-CoV-2 IgG consistent with seroconversion were present in 49 patients (47.6%). At the time of the second assessment, 91% (n=100) achieved seroconversion. Three months after the second dose, 83% (n=70) maintained levels of circulating SARS-CoV-2 IgG consistent with seroconversion. In this study, no SARS-CoV-2 infection was reported in the study population. Conclusions Our findings suggest that this group of patients had a satisfactory COVID-19 immunization response. Although promising, this study should be replicated on a wider scale in order to validate these findings.

摘要

引言 正在接受积极治疗的癌症患者感染2019冠状病毒病(COVID-19)的风险增加,因此进行有效的免疫接种至关重要。然而,疫苗接种在这一人群中的有效性仍不明确。本研究旨在评估一组接受免疫抑制治疗的活动性癌症患者对COVID-19的反应。方法 这是一项前瞻性、横断面、单中心研究,纳入了2021年4月至9月期间接受免疫抑制治疗并接种了COVID-19疫苗的癌症患者。排除标准为:既往已知的严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染、单剂量疫苗或未完成的疫苗接种方案。使用35.2结合抗体单位(BAU)/mL作为阳性临界值评估免疫球蛋白G(IgG)抗SARS-CoV-2抗体水平。在第一剂和第二剂接种后14 - 31天以及第二剂接种后三个月进行评估。结果 共纳入103例患者。中位年龄为60岁。大多数患者正在接受胃肠道癌(n = 38,36.9%)、乳腺癌(n = 33,32%)或头颈癌(n = 18,17.5%)的治疗。在评估时,72例患者(69.9%)接受姑息性治疗。大多数患者仅接受化疗(CT)(57.3%)。在首次评估时,49例患者(47.6%)的循环SARS-CoV-2 IgG水平与血清转化一致。在第二次评估时,91%(n = 100)实现了血清转化。第二剂接种后三个月,83%(n = 70)的患者循环SARS-CoV-2 IgG水平维持与血清转化一致。在本研究中,研究人群中未报告SARS-CoV-2感染。结论 我们的数据表明,这组患者具有令人满意的COVID-19免疫反应。尽管前景乐观,但本研究应在更大规模上重复进行以验证这些结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c324/10151022/be18d71d74c8/cureus-0015-00000037014-i01.jpg

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